Objective To investigate the efficacy of surgical decompression and spine stabilization combined with permanent 125I brachytherapy seed implantation in the treatment of metastatic epidural spinal cord compression(MESCC). Methods MESCC patients treated with surgical decompression and spine stabilization combined with permanent 125I brachytherapy seed implantation(study group,n=20) or surgical decompression and spine stabilization followed by radiotherapy(control group,n=40) were retrospectively analyzed between January 2012 and November 2014. Visual analogue scale(VAS) score,Karnofsky performance scale(KPS) score,neurological outcome,survival prognosis,and rates of complications were compared between the 2 groups. Results Postoperative VAS scores were significantly lower than preoperative those,and postoperative KPS scores were significantly higher than preoperative those in both groups(P <0.05). The VAS scores in the study group were significantly lower than the those in the control group at 1 week,1 months, and 3 months after surgery(P<0.05),and similar in both groups at postoperative 6 months. The KPS scores in the study group were significantly higher than those in the control group at 1 week,and 1 months after surgery(P < 0.05),and similar in both groups at postoperative 3 and 6 months. There were 18(90.0%) and 30(75.0%) patients having the ability to walk after surgery in the study and control group,respectively,with no significant difference. The median survival time was 7.0 months (95% confidence interval:4.3-13.7 months) and 6.6 months(95% confidence interval:3.8-9.0 months) in the study and control group,respectively,with no significant difference(P < 0.05). Complication occurred in 2(10.0%) patients in the study group and 15.0%(6/40) in the control group,with no significant difference(P > 0.05). Conclusion Surgical decompression and spine stabilization combined with permanent 125I brachytherapy seed implantation is superior to the treatment with decompressive surgery followed by radiotherapy in MESCC patients in terms of short term pain relief and improvement of performance status.

Objective: Radiation recall dermatitis (RRD) occurs in a previously irradiated field and is triggered by certain cytotoxic drugs or target drugs. A case of RRD caused by treatment with erlotinib 21 days after whole brain radiation therapy (WBRT) is reported. PATIENT AND Methods: A 56-year-old female patient with boon metastase of non-small cell lung cancer (T3N2M1) was found brain metases in MRI without symptom 3 months after diagnosis. She was treated with WBRT (Dt40Gy/20f/4weeks) and erlotinib (150mg/day) thereafter. Results:The patient developed rash, folliculitis and localized infection in her head skin 21 days after the first dose of erlotinib (grade 3 Radiation Therapy Oncology Group scoring criteria). The severity lesions were localized to head skin which limited in scope of WBRT. Erlotinib was stop and treatment to lesions was applied. The diagnosis of RDD induced by erlotinib was made. Conclusion:The use of Erlotinib after RT may trigger RRD. We advise clinicians to be cautious of RRD after erlotinib treatment. The drug should be unused and the treatment to severity lesions should be applied.

患者男,54岁,2006年11月行左肺切除术,术后病理为鳞癌,后未继续治疗.2009年5月发现左胸壁一约0.5 cm×0.5 cm大小肿物,未予重视,发展迅速,逐渐长到约2.5 cm×2.5 cm大小.一般状态不佳,呈恶病质,KPS 60分.